Note 6 - Accrued Expenses (Details) - Accrued Expenses - USD ($) $ in Thousands	Jun. 30, 2015	Dec. 31, 2014
Accrued Expenses [Abstract]
Accrued compensation and benefits	$ 11,630	$ 15,041
Accrued selling and professional fees	2,588	4,202
Accrued income, value added and other taxes	29,950	26,576
Accrued medical panel fees	4,515	4,391
Other accrued expenses	3,198	3,768
Totals	$ 51,881	$ 53,978